Pharm Test #1 Ch 29, 30, 31
A client is taking an OTC allergy product. The nurse would expect to find that this product most likely contains: phenylephrine. ephedra. epinephrine. albuterol.
phenylephrine. Phenylephrine is a common agent found in many OTC cold and allergy products. Ephedra has been banned by the Food and Drug Administration as a drug. Neither epinephrine nor albuterol are found in OTC products.
Norepinephrine is made by nerve cells using which substance? Glycogen Choline Decarboxylase Tyrosine
Tyrosine Norepinephrine is made by the nerve cells using tyrosine, which is obtained in the diet. Dihydroxyphenylalanine (dopa) is produced by a nerve, using tyrosine from the diet and other chemicals. With the help of the enzyme dopa decarboxylase, the dopa is converted to dopamine, which in turn is converted to norepinephrine in adrenergic cells.
Epinephrine causes relaxation of: smooth muscles in the intestinal wall. bronchioles. sphincter muscles. superficial blood vessels.
bronchioles. Epinephrine is the adrenergic drug of choice for relieving the acute bronchospasm and laryngeal edema of anaphylactic shock.
A nurse is providing teaching to a client prescribed midodrine. Which nursing instruction is very important that the client understands? "Midodrine is taken to lower your blood pressure, so you may feel a little light-headed after taking it." "Midodrine is taken for your glaucoma and should be put in your eyes upon waking in the morning." "Only take midodrine when standing. Taking it while lying down can cause very high blood pressure." "Only take midodrine when you have eaten first. It can cause ulcers if taken on an empty stomach."
"Only take midodrine when standing. Taking it while lying down can cause very high blood pressure." Midodrine is taken for orthostatic hypotension. It raises the blood pressure. It is only given while standing up because if given when lying down the blood pressure can rise to dangerous levels. Midodrine does not have to be taken with food to prevent ulcers. Midodrine is not an eyedrop used for glaucoma.
Which patient should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine? A 17-year-old female with symptoms of an upper respiratory infection A 47-year-old female with hypertension A 52-year-old male with adult-onset diabetes A 62-year-old male with gout
A 47-year-old female with hypertension Phenylephrine is an alpha-1 adrenergic agonist and a drug commonly used topically for relief of nasal and nasopharyngeal mucosal congestion and to produce mydriasis for ophthalmologic procedures. Phenylephrine acts as a vasopressor causing vasoconstriction of the arterioles. The vasoconstriction from phenylephrine use can increase peripheral resistance and blood pressure. People with hypertension should not take over-the-counter cold and allergy preparations containing phenylephrine because it can further increase their already elevated blood pressure. Patients with diabetes and gout have not been identified as being at risk for adverse reactions from the use of phenylephrine. A patient with an upper respiratory infection may actually benefit from use of the drug.
Which client is most likely to benefit from the administration of an adrenergic agonist? A woman who has been admitted with a suspected ischemic stroke A man who has a diagnosis of primary hypertension A woman who is in labor and may require a cesarean section A man who is in cardiogenic shock following a myocardial infarction
A man who is in cardiogenic shock following a myocardial infarction One of the most frequent indications for adrenergic agonist drugs is shock. Their use is contraindicated in labor, and they would exacerbate hypertension.
What neurotransmitter does the cholinergic system use? GABA Dopamine Acetylcholine Serotonin
Acetylcholine The cholinergic system uses acetylcholine as its neurotransmitter.
The nervous system is closely linked with both the immune system and the endocrine system. What neurotransmitter is used by the preganglionic cells? Serotonin Acetylcholine GABA Dopamine
Acetylcholine The neurotransmitter used by the preganglionic cells is acetylcholine (ACh); the neurotransmitter used by the postganglionic cells is norepinephrine. The other answers are not correct.
The nervous system is closely linked with both the immune system and the endocrine system. What neurotransmitter is used by the preganglionic cells? Dopamine GABA Serotonin Acetylcholine
Acetylcholine The neurotransmitter used by the preganglionic cells is acetylcholine (ACh); the neurotransmitter used by the postganglionic cells is norepinephrine. The other answers are not correct.
Nicotinic receptors would be found in which location? Bladder Adrenal medulla Gastrointestinal tract Sweat glands
Adrenal medulla Nicotinic receptors are found in the CNS, the adrenal medulla, the autonomic ganglia, and the neuromuscular junction. Muscarinic receptors are found in the sweat glands, bladder and GI tract.
The nurse is caring for a client who is experiencing pain. The client describes the pain as "9" on a scale of 1 to 10, with 10 being the worst pain. What nursing interventions would be necessary for the nurse to implement? Select all that apply. Check hemoglobin lab. Use Glasgow coma scale. Count respirations. Assess blood pressure. Evaluate pupils.
Assess blood pressure. Count respirations. Evaluate pupils. The sympathetic nervous system (SNS) is stimulated by physical or emotional stress, such as strenuous exercise or work, pain, hemorrhage, intense emotions, and temperature extremes. The client is experiencing an increase in blood pressure, cardiac output, respiratory rate, blood glucose, muscle strength, and pupillary dilation to aid vision. The nurse should assess vitals including blood pressure, respiratory rate, and pupils. The Glasgow coma scale is not warranted at this time nor is checking laboratory values such as hemoglobin.
Nicotinic receptors are found in which area? Autonomic basal ganglia Sweat glands Bladder GI tract
Autonomic basal ganglia Nicotinic receptors are located in the CNS, the adrenal medulla, the autonomic ganglia, and the neuromuscular junction. Muscarinic receptors are found in visceral effector organs, such as the GI tract, bladder, and heart; in sweat glands; and in some vascular smooth muscle.
A patient is admitted to the emergency room after a car accident. Based on the experience of the emergency room nurse, what system will affect a response to the emergency? Central nervous system Endocrine system Autonomic nervous system Cardiovascular system
Autonomic nervous system The functions of the autonomic nervous system can be described broadly as activities designed to maintain a constant internal environment (homeostasis), to respond to stress or emergencies, and to repair body tissues. The central nervous system regulates respiration or circulation. The endocrine system regulates hormone balance. The cardiovascular system regulates heart function.
The nurse is caring for a client with premedication data as follows: blood pressure (BP) 88/40 mm Hg, heart rate (HR) 45, respiratory rate (RR) 12, glucose 70 mg/dL, cardiac output (CO) 3.8 L/min (normal range 4-6 L/min). The nurse would predict which assessment findings after administering a sympathomimetic to the client? Select all that apply. RR 20 CO 3.5 L/min HR 40 BP 100/60 Glucose 150 mg/dL (8.32 mmol/L)
BP 100/60 Glucose 150 mg/dL (8.32 mmol/L) RR 20 A sympathomimetic medication has the same effects on the body as the sympathetic nervous system when activated. The "stress or emergency" or also called "fight-or-flight" response effects would include increased heart rate and blood pressure, increased cardiac output, hyperglycemia, or increased glucose, and increased respirations.
A client in distress has been given dobutamine, a medication intended to increase myocardial activity and heart rate. This medication likely stimulates what adrenergic receptor? Beta-1 Alpha-1 Beta-2 Alpha-2
Beta-1 Beta-1 stimulation increases myocardial activity. Alpha-1 stimulation leads to vasoconstriction and increased peripheral vascular resistance, resulting in a rise in blood pressure. Alpha-2 stimulation prevents overstimulation of effector sites and moderate insulin release by the beta cells of the pancreas. Beta-2 stimulation causes vasodilation and bronchodilation.
A patient has been administered dobutamine HCL. Which adverse reactions should the nurse monitor for in the patient? Sleeplessness Cardiac arrhythmias Urinary retention Elevated temperature
Cardiac arrhythmias The nurse should monitor for cardiac arrhythmias (bradycardia and tachycardia) because they are common adverse reactions observed in patients being administered dobutamine HCL. Dobutamine HCL does not cause urinary retention, elevated temperature, or sleeplessness.
In which areas are nicotinic receptors located? (Select all that apply.) Neuromuscular junction Adrenal medulla Central nervous system (CNS) Autonomic ganglia Peripheral nervous system (PNS)
Central nervous system (CNS) Adrenal medulla Neuromuscular junction Autonomic ganglia Nicotinic receptors are located in the CNS, the adrenal medulla, the autonomic ganglia, and the neuromuscular junction.
A nurse is caring for an elderly patient who is to be administered isoproterenol. Which change monitored in the patient should the nurse report immediately to the primary health care provider? Changes in pulse rate Changes in glucose level Changes in temperature Changes in appetite
Changes in pulse rate The nurse should report any changes observed in pulse rate or rhythm immediately. Changes in glucose level, appetite, or temperature need not be reported immediately to the primary care provider unless they are severe.
The nursing students are giving an oral presentation on the parasympathetic nervous system. How would they describe muscarinic receptors? Found only in preganglionic receptor sites Classification based on research with a mushroom plant alkaloid Classification based on research with a tobacco plant alkaloid Found only in the sympathetic nervous system
Classification based on research with a mushroom plant alkaloid This classification is based on very early research of the ANS that used muscarine (a plant alkaloid from mushrooms) and nicotine (a plant alkaloid found in tobacco plants) to study the actions of the parasympathetic system.
The home health nurse is caring for a 77-year-old male patient who has just been discharged from the hospital. The patient is taking dobutamine for congestive heart failure. What would be most important to monitor in this patient? Dietary intake Availability of caregivers Compliance with drug regimen Effectiveness of comfort measures
Compliance with drug regimen Monitor effectiveness of comfort measures and compliance with regimen. While it would be important to address all options given, it would be most important to monitor the patient's compliance with the drug regimen.
When there is stimulation of the SNS, blood is diverted away from the GI tract. What indicates this diversion? Decreased bowel sounds Increased blood pressure Decreased immune reactions Increased blood glucose levels
Decreased bowel sounds When blood is diverted away from the GI tract, bowel sounds decrease and digestion slows dramatically, sphincters are constricted, and bowel evacuation cannot occur. Increased blood glucose levels, elevated blood pressure, and decreased immune reaction are due to SNS stimulation, but are not concerned with the GI tract.
The nursing instructor is explaining the role of the parasympathetic nervous system in influencing body functions. Which change in a patient's body functions would be directly related to the stimulation of the parasympathetic nervous system? Poor motility of the gastrointestinal tract Decreased heart rate Increased heart rate Pupil dilation
Decreased heart rate Specific body responses to parasympathetic stimulation include decreased heart rate, increased motility of the gastrointestinal tract, and pupil constriction.
The nursing instructor is explaining the role of the parasympathetic nervous system in influencing body functions. Which change in a patient's body functions would be directly related to the stimulation of the parasympathetic nervous system? Pupil dilation Decreased heart rate Increased heart rate Poor motility of the gastrointestinal tract
Decreased heart rate Specific body responses to parasympathetic stimulation include decreased heart rate, increased motility of the gastrointestinal tract, and pupil constriction.
A client with early stage Alzheimer's disease has been prescribed galantamine, which the nurse recognizes as a nicotinic receptor agonist. When assessing the client, what finding should the nurse attribute to the drug's effect on the autonomic nervous system? Urinary retention with post-void residual of 375 mL Blood urea nitrogen of 8.9 mmol/L (25 mg/dL) Heart rate 61 beats per minute Oral temperature 37.6°C (99.7°F)
Heart rate 61 beats per minute Stimulation of nicotinic receptors in the parasympathetic nervous system causes a reduction in heart rate. Urinary frequency would be more likely than hesitancy or urinary retention. Temperature and blood urea nitrogen levels would not likely be affected directly.
What is the resulting physiologic effect when the parasympathetic nervous system is stimulated? Decreased GI secretions Pupil dilation Increased GI motility Increased heart rate
Increased GI motility When the parasympathetic nervous system is stimulated, the result is increased GI motility, decreased GI secretions, decreased heart rate, and pupillary constriction, which all result from stimulation of the sympathetic nervous system.
What is the resulting physiologic effect when the parasympathetic nervous system is stimulated? Pupil dilation Increased heart rate Increased GI motility Decreased GI secretions
Increased GI motility When the parasympathetic nervous system is stimulated, the result is increased GI motility, decreased GI secretions, decreased heart rate, and pupillary constriction, which all result from stimulation of the sympathetic nervous system.
Which outcomes should the nurse consider to be side effects of a selective cholinergic agonist based upon the characteristics of the prescribed medication? Select all that apply. Pupil dilation Heart rate 110 Increased drooling of oral secretions Blood pressure 88/50 mm Hg Abdominal cramping
Increased drooling of oral secretions Abdominal cramping Blood pressure 88/50 mm Hg TThe cholinergic medication acts as an agonist and selectively binds to the muscarinic receptors, altering the function of the receptors and eliciting the physiologic responses associated with them. The medication stimulates the activity of the parasympathetic nervous system, resulting in the side effects of sweating, increased salivation, abdominal cramping because of smooth muscle contractions in the gastric area, and low blood pressure or hypotension. Tachycardia and pupil dilation would occur when an adrenergic medication was administered, resulting in sympathetic nervous system stimulation.
A patient is experiencing a heart rate of 42 beats per minute. Which system contributes to bradycardia? Autonomic nervous system Pulmonary system Parasympathetic nervous system Peripheral vascular system
Parasympathetic nervous system The parasympathetic nervous system decreases heart rate. The pulmonary system will not regulate bradycardia. The autonomic nervous system increases heart rate. The peripheral vascular system regulates blood flow to the extremities.
The nurse is caring for a client with asthma who has been experiencing shortness of breath and who has been administered a medication to cause bronchodilation. What aspect of autonomic nervous function has the nurse most likely influenced? Inhibition of alpha-adrenergic receptors Synthesis of acetylcholinesterase Reuptake of acetylcholine Stimulation of beta-adrenergic receptors
Stimulation of beta-adrenergic receptors Stimulation of beta receptors causes bronchodilation, which is the therapeutic effect of several medications for asthma. The bronchi are not primarily affected by the presence of acetylcholine receptors. Inhibiting the alpha adrenergic receptors does not cause bronchodilation.
A nurse is monitoring the vital signs of a patient who has been administered epinephrine. Which of the readings should nurse report immediately to the primary health care provider? Systolic blood pressure below 100 mm Hg Pulse rate of 60 beats per minute Temperatures reading of 97.6°F A diastolic blood pressure of 75 mm Hg
Systolic blood pressure below 100 mm Hg The nurse must immediately report to the health care provider a fall in systolic blood pressure below 100 mm Hg. Epinephrine should raise the blood pressure, so a continued low systolic pressure indicates the medication has not been effective. A diastolic blood pressure of 75 mm Hg, a pulse rate of 60 beats per minute, and a temperature reading of 97.6°F are normal and need not be reported immediately.
The nurse is conducting an assessment of a newly admitted client. What assessment finding should suggest to the nurse that the client's muscarinic cholinergic receptors are being stimulated? The client describes a frontal lobe headache. The client's attention span is unusually short. The client's blood pressure is 119/72 mmHg. The client has "pinpoint" pupils.
The client has "pinpoint" pupils. Pupil constriction is among the effect of parasympathetic stimulation of muscarinic cholinergic receptors. Pain and cognition are not affected by these receptors. The client's blood pressure is well within acceptable ranges; there is no obvious indication of parasympathetic stimulation.
The physiology instructor explains to the nursing students that beta-2 stimulation leads to: Vasodilation of the aortic valve Vasoconstriction of blood vessels Vasoconstriction of the aortic valve Vasodilation of blood vessels
Vasodilation of blood vessels In blood vessels, beta-2 stimulation leads to vasodilation.
A client experiencing a serious allergic reaction to a bee sting is brought to the emergency department. The client's right hand is swollen, red, and painful. She is extremely upset, short of breath, and the nurse detects wheezing and stridor. The nurse is ordered to administer epinephrine to relieve which of the clients symptoms? discoloration in her hand. acute bronchospasm. pain and swelling around the sting site. acute anxiety.
acute bronchospasm. The client is most likely experiencing anaphylaxis, and the epinephrine is being given to produce bronchodilation by stimulation of beta-2 adrenergic receptors and is the drug of choice to treat anaphylactic shock. The epinephrine does not directly affect the pain, redness, or swelling. It can actually add to anxiety because it stimulates all adrenergic receptors and can cause CNS excitation.
A nurse is caring for a patient who is having a sympathetic response. A sympathetic response involves: a decrease in heart rate, decrease in blood flow to skeletal muscles, and increase in inflammatory reactions. increased motility, secretions in the GI tract, and constriction of bronchi and pupils an increase in blood pressure, bronchi dilation, and decreased bowel sounds a decrease in sweating, decrease in respirations, and pupil constriction.
an increase in blood pressure, bronchi dilation, and decreased bowel sounds Increase in blood pressure, bronchi dilation, and decreased bowel sounds are responses to sympathetic stimulation. Decrease in sweating, respirations, heart rate, and blood flow to skeletal muscles and increase in motility and secretions of GI tract and inflammatory reactions, and pupil and bronchi constrictions indicate parasympathetic stimulation.
Sympathetic stimulation of the heart causes: an increased rate and force of myocardial contraction. a decreased rate and force of myocardial contraction. an excitatory response that stimulates the brain to generalized decreased activity. decreased blood flow and impaired digestion.
an increased rate and force of myocardial contraction. Stimulation of the ANS causes excitatory effects in some organs but inhibitory effects in others. For example, sympathetic stimulation of the heart causes an increased rate and force of myocardial contraction; parasympathetic stimulation decreases rate and force of contraction, thereby resting the heart.
A client with chronic obstructive pulmonary disease (COPD) is experiencing bronchoconstriction. When choosing interventions to address this problem, the nurse should aim to influence the client's autonomic nervous system by stimulating: acetylcholine release. alpha-adrenergic receptors. beta-adrenergic receptors. the parasympathetic response.
beta-adrenergic receptors. Stimulation of beta-receptors of the sympathetic nervous system causes bronchodilation. Alpha-receptors has a less pronounced effect. Acetylcholine and the parasympathetic response are associated with bronchoconstriction.
A nurse in the intensive care unit is caring for a client in shock and has started IV administration of dopamine (Intropin). For a client in shock, dopamine helps to: decrease heart rate. increase blood pressure. increase body temperature. decrease blood pressure.
increase blood pressure. For a client in shock, dopamine helps to increase blood pressure. The alpha stimulation produces increased peripheral resistance, raising the blood pressure as the dose of dopamine increases. The drug's dosage is titrated upward until adequate perfusion of vital organs is achieved. Beta-1 stimulation produces increased cardiac output by increasing the force of contraction and heart rate. The drug does not have a direct effect on body temperature.
An adrenergic drug would be prescribed to produce what physiological effect? decreased respiratory rate urine concentration decreased blood pH increased heart rate
increased heart rate Adrenergic drugs cause an increase in heart rate and respiratory rate. They do not directly induce urinary incontinence concentration, and they do not reduce blood pH.
The nurse is caring for a client with asthma who has been administered albuterol in order to promote bronchodilation and relieve shortness of breath. When giving this medication, the nurse has affected the client's autonomic nervous system by: decreasing the reuptake of acetylcholine. converting a larger proportion of dopamine to norepinephrine. stimulating beta2-receptors. antagonizing alpha2-receptors.
stimulating beta2-receptors. Stimulation of beta2-receptors causes bronchial dilation. Manipulation of acetylcholine levels does not cause this effect, not does increasing norepinephrine levels. Antagonizing the alpha2-receptors would not have this effect.
Adrenergic drugs mimic the effects of stimulating what part of the nervous system? autonomic central parasympathetic sympathetic
sympathetic An adrenergic drug is an agent that produces effects like those produced by stimulation of the sympathetic nervous system and therefore has widespread effects on body tissues. These drugs do not mimic the effect of the parasympathetic nervous system. The autonomic nervous system comprises the sympathetic and parasympathetic systems.
The nurse educates a client diagnosed with asthma concerning the important aspects about the prescribed selective beta2-adrenergic agonist inhaler. Which client statement indicates the need for further clarification? "Beta2 receptors are in the respiratory tract and the bronchi." "The medication will bind to beta2 receptors and activate the physiologic response." "The inhaler will cause my bronchi to dilate and make it easier for me to breathe." "The medication will cause my heart rate to increase and will cause palpitations."
"The medication will cause my heart rate to increase and will cause palpitations." The nurse needs to clarify teaching regarding that the medication is selective to beta2 receptors that affect bronchodilation. The medication does not significantly activate beta1 receptors leading to tachycardia or palpitations. The definition of agonist is that the medication will bind to the beta2 receptors and activate the physiologic response, and in this case, the sympathetic nervous system.
A client is experiencing sympathetic stimulation in response to a stressful event. Which substance will most affect the client's sodium and water retention? Thyroid hormone Aldosterone Glucose Cortisol
Aldosterone Aldosterone causes sodium and water retention and potassium excretion. Thyroid hormone increases metabolism and efficient use of energy. The release of adrenal hormones, including cortisol, suppresses the immune and inflammatory reactions to preserve energy during the fight or flight response. Glucose is formed by glycogenolysis to increase the blood glucose level and provide energy.
The nurse understands that vasoconstriction that leads to a rise in blood pressure is due to stimulation of which type of receptor? Beta-1 Beta-2 Alpha-1 Alpha-2
Alpha-1 Alpha-1 stimulation leads to vasoconstriction and increased peripheral vascular resistance resulting in a rise in blood pressure. Alpha-2 stimulation prevents overstimulation of effector sites and moderate insulin release by the beta cells of the pancreas. Beta-1 stimulation increases myocardial activity. Beta-2 stimulation causes vasodilation and bronchodilation.
A client with asthma is prescribed albuterol to dilate the bronchioles. The nurse understands that this drug is likely acting on which receptors? Beta-2 Beta-1 Alpha-2 Alpha-1
Beta-2 Bronchodilation occurs with stimulation of beta-2 receptor sites. Vasoconstriction and increased peripheral vascular resistance occurs with alpha-1 receptor stimulation. Overstimulation of effector sites and moderate insulin release occurs with alpha-2 stimulation. Increased heart rate occurs with beta-1 receptor stimulation.
The anatomy and physiology instructor is discussing adrenergic receptors with the nursing class. What adrenergic receptor would the instructor tell the students is found in the heart and can stimulate increased myocardial activity and increase heart rate? Beta1 Alpha2 Beta2 Alpha1
Beta1 B1 receptors are found in cardiac tissue where they can stimulate increased myocardial activity and increased heart rate. Alpha1 receptors are found in blood vessels, in the iris, and in the urinary bladder. Alpha2 receptors are located on nerve membranes and act as modulators of norepinephrine release. Beta2 receptors are found in smooth muscle in blood vessels, in the bronchi, in the periphery, and in uterine muscle.
Which effect results from activation of beta2 receptors? Bronchodilation Pupil constriction Decreased heart rate Bronchoconstriction
Bronchodilation Activation of beta2 receptors results in bronchodilation.
Which type of cells synthesizes and store norepinephrine and epinephrine? Neuroeffector Pancreatic Chromaffin Basal
Chromaffin The chromaffin cells of the adrenal medulla synthesize, store, and release norepinephrine, as well as epinephrine.
The nurse is caring for a client who is known to have deficient levels of dopamine because of a dietary lack of tyrosine. The nurse should expect to assess for evidence of: decreased adrenergic response. hyperfunction of the sympathetic nervous system. increased adrenergic response. overstimulation of nicotinic receptors.
Decreased adrenergic response. Dopamine is a precursor to norepinephrine, which is one of the two major postganglionic neurotransmitters of the sympathetic nervous system. Consequently, low levels of dopamine could plausibly lead to a decreased adrenergic response. This would not affect the function of cholinergic neurons. Hypofunction, not hyperfunction, of the SNS would be likely.
When there is stimulation of the SNS, blood is diverted away from the GI tract. What indicates this diversion? Decreased immune reactions Increased blood pressure Increased blood glucose levels Decreased bowel sounds
Decreased bowel sounds When blood is diverted away from the GI tract, bowel sounds decrease and digestion slows dramatically, sphincters are constricted, and bowel evacuation cannot occur. Increased blood glucose levels, elevated blood pressure, and decreased immune reaction are due to SNS stimulation, but are not concerned with the GI tract.
The nurse is assessing a client who received epinephrine, an adrenergic drug, for the treatment of cardiac arrest. The nurse would expect to observe what effect of the drug? Urinary retention Decreased kidney perfusion Increased heart rate Decreased respiratory rate
Increased heart rate Adrenergic drugs are used in cardiac arrest for their cardiac stimulant and peripheral vasoconstrictive effects. They do not directly impact respiratory rate, urination, or kidney perfusion.
The body uses tyrosine in the diet to make what substance? Norepinephrine Serotonin Estrogen Glutamate
Norepinephrine Norepinephrine is made by adrenergic nerves using tyrosine from the diet.
A graduate of a nursing program is scheduled to take the NCLEX today. The test-taker's heart is racing and pupils are dilated. What can the test-taker attribute to this reaction? The release of dopamine Cardiovascular irregularity Sympathetic nervous system Autonomic nervous system
Sympathetic nervous system The sympathetic nervous system is stimulated by physical or emotional stress, such as strenuous exercise or work, pain hemorrhage, intense emotions, and temperature extremes. The specific body responses include increased arterial blood pressure and cardiac output and pupil dilation to aid vision. The autonomic nervous system affects the cardiovascular function to decrease heart rate responses. The patient does not suffer from a cardiac irregularity. The release of dopamine will not affect pupillary response.
A client has had a stroke and computed tomography reveals infarcts in multiple brain regions. An infarct in which region is most likely to affect the function of the client's autonomic nervous system? Amygdala Hypothalamus Parietal cortex Ventricular system
Hypothalamus The hypothalamus plays a major role in the coordination of autonomic nervous system function. The parietal cortex primarily regulates touch and sensation. The amygdala contributes to memory and decision making. The ventricular system contributes to the production and distribution of cerebrospinal fluid.
CHAPTER 29
Chapter 29
CHAPTER 30
Chapter 30
Neurons communicate through the use of synapses. These synapses may link neurons into functional circuits. How do the neurons communicate through the synapses? Chemically Excitatorily Inhibitorily Electrically
Chemically Norepinephrine, a neurotransmitter, belongs to a group of structurally related chemicals called catecholamines that also includes dopamine, serotonin, and epinephrine. Neurons do not communicate electrically, excitatorily, or inhibitorily.
nurse is caring for a patient who is on a drug regimen of midodrine to treat hypotension. What would be an appropriate nursing diagnosis to include in the care plan of this patient? Impaired skin integrity related to dermatological effects Acute pain related to GI distress, cough, skin effects, and headache Offer support and encouragement to help the patient deal with the diagnosis and the drug regimen Disturbed sensory perception (visual, kinesthetic, tactile) related to CNS effects
Disturbed sensory perception (visual, kinesthetic, tactile) related to CNS effects Nursing diagnoses related to drug therapy with might include ineffective tissue perfusion (total body) related to changes in cardiac output and disturbed sensory perception (visual, kinesthetic, tactile) related to CNS effects. Acute pain is a nursing diagnosis appropriate to a patient receiving an ARB. Support and encouragement is an implementation, not a nursing diagnosis. Impaired skin integrity is a nursing diagnosis for a patient taking an ACE inhibitor.
Which would the nurse identify as a naturally occurring catecholamine? Ephedrine Dobutamine Dopamine Metaraminol
Dopamine Dopamine is a naturally occurring catecholamine. Dobutamine, ephedrine, and metaraminol are synthetic catecholamines.
Which herbs has been removed from most weight-loss medications due to potential legal liability? Ephedra Rose hips Gingko Ginseng
Ephedra Ephedra has serious adverse reactions, such as hypertension and irregular heart beat. These side effects have been associated with stroke and heart attacks. The Food and Drug Administration has warnings against taking weight-loss pills that have ephedra in them. Gingko, ginseng, and rose hips have not had these serious side effects.
An instructor is preparing a teaching plan for a group of students about adrenergic agonists. Which would the nurse include as an alpha- and beta-adrenergic agonist? Phenylephrine Albuterol Epinephrine Terbutaline
Epinephrine Epinephrine is an alpha- and beta-adrenergic agonist. Phenylephrine is an alpha-specific adrenergic agonist. Albuterol is a beta-specific adrenergic agonist. Terbutaline is a beta-specific adrenergic agonist.
A client is experiencing anaphylaxis. What drug will the nurse most likely administer? Norepinephrine Dantrolene sodium Acetylcysteine Epinephrine
Epinephrine Epinephrine is the adrenergic drug of choice for relief of anaphylactic shock, the most serious allergic reaction, as well as in treatment of cardiac arrest. Norepinephrine used to treat severe hypotension and shock that persists after adequate fluid volume replacement. Acetylcysteine is used for acetaminophen overdose. Dantrolene sodium is used to treat malignant hyperthermia.
Which would the nurse expect to be prescribed to a client experiencing acute bronchospasm? Norepinephrine Epinephrine Metaraminol Dopamine
Epinephrine Epinephrine would be used to treat bronchospasm. Dopamine is indicated for the treatment of congestive heart failure. Metaraminol is used to treat shock if norepinephrine or dopamine cannot be used. Norepinephrine is used to treat shock and during cardiac arrest to promote sympathetic activity.
The nurse assessed a client at 0800 and obtained a blood pressure of 111/70 mmHg. Two hours later, the client's blood pressure is 130/81 mmHg. The nurse should attribute this change to what action within the autonomic nervous system? Stimulation of beta-receptors Antagonism of alpha-receptors Decreasing levels of acetylcholinesterase Stimulation of nicotinic receptors
Stimulation of beta-receptors Increased blood pressure is among the effects of sympathetic nervous stimulation through activation of beta-receptors. Alpha receptors also affect blood pressure, but antagonism of these receptors would blood this hypertensive effect. Acetylcholine is involved in the physiology of the parasympathetic nervous system, which generally lowers blood pressure; low levels of acetylcholinesterase could plausible lower blood pressure by increasing the effects of acetylcholine on the parasympathetic receptors. Stimulation of nicotinic receptors is associated with reduced blood pressure.
